Re: Still need code for deep tissue verse G5

[Guest guest]

Walt -

In response to your question, there is no specific code that separates massage into different classifications, deep or otherwise. If you are performing (deep tissue) massage bill using CPT code 97124, noting the time to support the number of units submitted.

Manual therapy is a code with specific limitations when performed on the same day as any manipulation (see below). You would be better off using the massage code, since you say you are performing massage. CPT requires the provider to use the code that accurately describes the procedure performed, not an approximation.

That brings us to your use of a “massaging type†device. These external units do not meet the definition for billing with the massage code. The code requires direct patient - provider interactions along with actual massage by the provider. G-5 type devices do not have a CPT code describing what is performed. The best option would be to use the unspecified physical therapy modality code (CPT code 97039) and provide a detailed explanation in your notes. You mention that it is for “relaxation†which suggests that it is not being used to treat a specific diagnosed condition, and payment may be declined.

Below is a reprint (edited) of an article I wrote last fall on the manual therapy code. I have provided this to the list before, but here it is again. I hope it helps.

Tom Freedland, D.C.

Revisiting CPT Code 97140 (edited for this message)

The manual therapy code (97140) was first introduced in the 1999 edition of the AMA Current Procedural Terminology (CPT). It was a compromise code; at the time the physical therapists were interested in a stair-stepping type of code similar to the multiple regions reflected in the chiropractic manipulative therapy codes (CMT) and the osteopathic manipulative therapy codes (OMT). A staggered code did not result, but manual therapy (CPT code 97140) became a hybrid eliminating CPT codes 97260 and 97261, manipulation, CPT code 97265, joint mobilization, CPT code 97122, manual traction, and CPT code 97250, myofascial release. The new code was entitled manual therapy, manipulation, and mobilization of soft tissue. The inclusion of the word “manipulation†presented the first problem and it was seen as duplicative of osteopathic or chiropractic manipulation; thus, was designated within the Current Code Initiative Edits (CCI Edits) as a subset zero (0) meaning that under no condition could the code be simultaneously submitted with any of the manipulative codes.

This presented issues since the eliminated myofascial release code did not have similar prohibitions. Many providers who performed a form of deep tissue therapy to reduce muscle spasms or tissue adhesions in conjunction with manipulation needed an alternative to reflect the services performed. Massage therapy (CPT code 97124) was one option, but many times patients were receiving massage therapy from a separate therapist and the service was seen as redundant.

Some guidance came about in 2006 when CPT Assistant reviewed some of these ongoing concerns. With this and subsequent reviews, certain procedure codes were clarified as to their appropriate billing with other procedure codes. Manual therapy was reclassified allowing it (CPT code 97140) to be submitted on the same day and same visit as chiropractic manipulation (CPT codes 98940 – 98943) or osteopathic manipulation (CPT codes 98925 – 98929) provided it is documented within the chart notes as being performed to an area other than where the manipulation has been performed and it is submitted with a modifier “59†indicating a distinct and separate procedure.

To: oregondcs Sent: Saturday, June 30, 2012 7:24:20 PMSubject: Still need code for deep tissue verse G5

I have here from past list server talk the code 97140-59 is for Deep tissue but it is also coded for manual therapy, which means that the insurance really does not know it is deep tissue.

Then I have 97124-59 for massage (15-minutes)

However I do not have a code for G5. If I am also doing deep tissue prior to adjustment and then after the G5 for relaxation I don't know how to use codes for both these without their own codes.

DOES ANYONE HAVE AN ANSWER, PLEASE. THANK YOU

WALT DC

EAGLE PT.